Blood Test Results

[Crazy_Diamond]

Would someone please be able to tell me what these blood test results mean please? I did add them on to a previous thread but I don't think they were showing up.

I was told by my GP back in July that my TSH levels were low . I admitted that I did sometimes forget to take Levo so she wanted me to go 2 months without missing a dose and do another test late October. She has included the Iron Panel that someone suggested getting done as my Ferritin levels are always out of range. I also have high cholesterol. I have read that this is a symptom of having Hashies. Would this be correct?

Thank you. Much appreciated!

Serum TSH level 0.5 mIU/L 0.35 - 4.94 mIU/L

Serum vitamin B12 438 ng/L 200 - 900 ng/L

Full blood count - FBC

Total white cell count 6.7 10*9/L 4 - 11 10*9/L

Haemoglobin estimation 146 g/L 115 - 165 g/L

Platelet count 257 10*9/L 150 - 450 10*9/L

Red blood cell (RBC) count 4.8 10*12/L 3.8 - 5.8 10*12/L

Haematocrit 0.435 1/1 0.37 - 0.47 1/1

Mean corpuscular volume (MCV) 90.6 fL 76 - 98 fL

Mean corpusc. haemoglobin(MCH) 30.4 pg 27 - 32 pg

Mean corpusc. Hb. conc. (MCHC) 336 g/L 300 - 360 g/L

Red blood cell distribut width 12 % 11 - 15 %

Mean platelet volume 10.3 fL 8.5 - 10.0 fL

Neutrophil count 3.7 10*9/L 2 - 7 10*9/L

Lymphocyte count 2.4 10*9/L 1 - 4 10*9/L

Monocyte count 0.4 10*9/L 0.2 - 0.8 10*9/L

Eosinophil count 0.2 10*9/L 0 - 0.4 10*9/L

Basophil count 0.1 10*9/L 0 - 0.2 10*9/L

Serum folate 14.9 ug/L 3.0 - 20.5 ug/L

IRON STUDIES

Serum iron level 20 umol/L 9 - 30 umol/L

Serum transferrin 2.3 g/L 1.80 - 3.82 g/L

Transferrin saturation index 33 % 15 - 50 %

Serum ferritin 365 ug/L 30 - 250 ug/L

FULL LIPID PROFILE

Serum cholesterol 6.7 mmol/L - mmol/L

Serum HDL cholesterol level 1.09 mmol/L 1.20 - 5.00 mmol/L

Serum triglycerides 2.8 mmol/L 0 - 1.7 mmol/L

Serum cholesterol/HDL ratio 6.1 -

Serum LDL cholesterol level 4.3 mmol/L - mmol/L

Se non HDL cholesterol level 5.6 mmol/L - mmol/L

[greygoose]

Forgetting to take your levo would not cause your TSH to be low, on the contrary. If you missed your dose too often, your TSH would rise. Did your doctor really accept that as a reason for your low TSH?

Just testing TSH is useless. Once it gets below 1 it doesn't tell you anything. The important number are the FT3 first, and FT4 second. Testing TSH won't tell you what those levels are. So you can have no idea of your true thyroid status.

But, if your cholesterol is high then your FT3 is probably low, because it's low T3 that causes high cholesterol, not having Hashi's.

Your B12 is a little low, but your folate is good.

Your ferritin is high but your serum iron is good, so you probably have high levels of inflammation. But they don't seem to have tested for that. Ferritin and CRP (inflammation marker) should always be tested together.

[Crazy_Diamond in reply to greygoose]

Hi Greygoose,

Apologies, I think I got that the wrong way round. This was in my notes '....test result TSH slightly elevated @4.29. T4 normal....'

Thank you.

[greygoose in reply to Crazy_Diamond]

Ah, so your doctor actually said that your TSH was high?

Anyway, apart from that, the rest of what I said still holds true.

[Crazy_Diamond in reply to greygoose]

Yes. I had it in my head that it was low. I'm assuming that my doctor is happy with this result as she has not contacted me to say otherwise!

Thank you so much for looking at these for me.

Also, really enjoyed reading your story on your bio. Sounds like you went through a really tough time!

[greygoose in reply to Crazy_Diamond]

Yes, she would be happy with it, it's now in-range. But it doesn't tell her anything about your thyroid status, or if you need an increase in dose. You really, really need your thyroid hormones tested: FT4 and FT3. TSH is a pituitary hormone.

[SlowDragon Administrator in reply to Crazy_Diamond]

This was in my notes '....test result TSH slightly elevated @4.29. T4 normal....'

This refers to your previous test

That’s not what test result here says

Serum TSH level 0.5 mIU/L 0.35 - 4.94 mIU/L

High ferritin

How old are you?

Post menopause?

You need to get FULL thyroid testing - TSH, Ft4 and Ft3

and essential to test vitamin D

What vitamin supplements are you taking

Many (Most?) Hashimoto’s patients need to self supplement vitamin D, magnesium and vitamin B complex daily

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

healthunlocked.com/thyroidu...

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/getting-a-dia...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/getting-a-dia...

or just vitamin D

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Are you on strictly gluten free/dairy free diet

[Crazy_Diamond in reply to SlowDragon]

Yes the TSH @ 4.9 was from the previous blood test.

High ferritin - GP never concerned about it being out of range

Age: 64, diagnosed in 2007

Post menopause, yes

Vitamins: Vit D (20000 IU daily), K2 (1200mcg), Zinc, Vit C, Turmeric (to reduce Cholesterol, which is clearly not working), Vit A.

Last test was done at 9.30am. No food, only water. No Levo was taken prior to test.

Not on a gluten free/dairy free diet.

Thank you for all the info. Will need to process it all 🙂

[SlowDragon Administrator in reply to Crazy_Diamond]

High ferritin is normal after menopause.

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Bioche

Ideally you need full iron panel every 2-3 years just to check iron not too high …or too low

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

[SlowDragon Administrator in reply to Crazy_Diamond]

high cholesterol linked to low Ft3

You need to test TSH, Ft4 and Ft3 together

Suggest you take daily vitamin B complex to improve B12

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[humanbean]

When people are hypothyroid (have underactive thyroid) their test results usually show :

High TSH

Low Free T4

Low Free T3

When people are hyperthyroid (have overactive thyroid) their test results usually show :

Low TSH

High Free T4

High Free T3

So, when a medical professional tells someone who is undiagnosed they have "low thyroid" and since so many doctors make mistakes in interpreting thyroid results, it isn't clear whether they are saying "low thyroid" refers to Low TSH (probably hyperthyroid) or low Free T4 or low Free T3 (both of which happen in hypothyroidism).

There is another problem when the patient is diagnosed. Suppose a patient is hypothyroid and they see a doctor and get tested, and their TSH is low in range or below range. The doctor sometimes tells this hypothyroid patient on treatment that they have become hyperthyroid. This is not true, although if the patient has Hashi's, results can fluctuate. People who are hypothyroid cannot become hyperthyroid. But they can be over-medicated. To fix over-medication usually just needs a small reduction in dose. But when telling the patient they are "hyperthyroid" some doctors panic and take their patient off thyroid hormones altogether, or they make massive cuts in their dose. And then they make their sick patient much, much sicker.

There is far more to thyroid conditions than I've just explained, and other patterns of TSH/Free T4/Free T3 can occur than I've listed at the start of this reply. For example, in the early days of thyroid failure the body/thyroid will respond by creating far less T4 than a healthy thyroid should and a lot more T3 than normal.

[Crazy_Diamond in reply to humanbean]

Thank you for this very interesting information. It all helps me to understand it a little more than I do.